Knowledge about sickness, death and other misfortunes is colored by perceptions of the body and how it functions, the place of the individual in the social order, and the cosmological forces that affect human beings. Many studies of local knowledge systems emphasize the “exotic” causes to which chronic conditions and disabilities are attributed. Witches, spirits or pollution resulting from improper behaviour may be regarded as the causes of mental or physical impairment. Such cultural explanations are ways of putting disability in context, of making sense of it in relation to social conflicts, moral lapses and the influence of unseen powers. They help people to understand an individual’ s condition in terms of the whole life situation.

Identifying causes is often a first step towards treatment. In many health cosmologies, dealing with the reason for a condition holds out the hope of a permanent cure. Dealing merely with symptoms may only give temporary relief until another disaster strikes; the underlying social and moral problems remain. Eliminating pollution, counteracting witchcraft or making offerings to spirits are efforts to tackle the powers responsible for problems and thus to solve them once and for an.

Of course, it often happens that a person with a disability does not improve when measures of these kinds have been adopted. Other causes may then be sought until the affected family accepts that the condition cannot be changed. It is this point that people in East Africa begin to speak of the “work of God”, unalterable by the efforts of humans. The difference between misfortunes which can be dispelled and the workings of fate which cannot be changed only becomes evident over time.

In contrast rehabilitation programmes are based on the cultural belief that disability can be diminished through constant effort, training, individual adjustment and, to some extent, environmental adaptation. The goal is improved function, not cure. The individual is the Object of long terra special attention. Here technical aids and training are the key, rather than attempts to eliminate the wider social and moral causes of the problem. Rehabilitation officers complain that families are insufficiently committed to such extended efforts over months and years, and that they are disappointed when there is no immediate improvement. There is a cultural gap but the problem is not necessarily that people trapped by traditional beliefs about disability. Culture is a matter of experience and most people in developing countries have little experience of the results of effective rehabilitation programmes. Consequently there is little commitment and confidence until the value of programmes has been demonstrated.

Of the following statements, which is true for the passage?